Must read for the office workers with back and neck pain
One of the most common ways patients present to us is with nasty acute back or neck pain following a very trivial incident. For example “my backs always been fine but last weekend I was putting on my shoes and it went” or “I was just drying my hair with a towel and it went into spasm”. In probably 9/10 of these cases, once we look into the patient’s situation through a thorough history and examination we invariably find that never could a cliche be truer than “the straw that broke the camel’s back”. We all love a scapegoat and without looking deeper it is easy to blame the small incident as the cause of an injury and manage it trivially as such. But if you think about it how many thousand times have you put your shoes on or dried your hair or whatever task it was that set off the injury and never had a problem performing that with no issues?
The real answer is to look at what we are doing day-to-day with our routines, habits, postures, work and hobbies to find out what has caused an accumulation of stress and irritation on structures and tissues leading up to an injury. For office and sedentary workers the main area to look will be at the desk and chair setup where even seemingly small habits or issues can slowly snowball over time into a significant irritation, injury or imbalance. We’ve all been at the induction to a new role and paid lip service to HR’s ergonomics training or demonstration. While this may seem like a tick box exercise looking at pictures of a stick man sitting with perfect posture and nice right angles to avoid litigation on the company’s part, these principles are very important as a few degrees tilt or twist the wrong way or a bit of round shouldered slouching represents a huge amount of cumulative force over time.
The human body unfortunately is not particularly designed to sit for long periods. Even though sitting is a passive and seemingly restful position, much higher loads are imparted on the spinal discs in a sitting posture than in standing as we decrease the natural curvature that disperses the forces through multiple levels and structures. So anything we can do to reduce or minimise this prolonged loading is good practice to help recover from injury as well as a preventative measure. All the best manipulation, massage, acupuncture and exercise will do little long term to fight the tide of chronic overload if good habits aren’t in place day to day. If we had to state the most stereotypical desk sitting posture mistakes, in men it is to slouch in a rounded position and poor alignment and in women it is often the opposite, perching on the front of the chair and sitting in a very upright position but too rigidly with too greater muscle activity leading to increased compressive forces.
The ideal is to be somewhere in the middle, your bottom should be right back in the corner of the chair so the lower back can be touching the lumbar support up to at least the mid back area. Basically your bum and back should be touching the backrest most of the time. How high the backrest goes up is more personal preference and comfort as long as the lower half of the spine is supported the shoulders and neck should sit in good alignment. Having established the ideal best static position to be in when sitting at a desk, even when in perfect alignment as mentioned above we are not particularly designed to sit or be still for long periods at at time and stress, overload and compression will occur eventually. So with this in mind a cheesy old physio expression is very valid ‘The Best Posture Is The Next Posture’, meaning ideally we should change positions, postures and activities as often as possible to keep moving, allowing the body to use different joints and muscles and stimulate blood flow.
The growing trend of standing desks (which at a push of a button move from a sitting working height to a standing working height) is a good one as it allows the body to move to a different position for periods throughout the day. For those without this luxury simply remembering to stand up when taking a phone call, using a small glass of water or bottle that needs refilling every half hour, setting a pop up reminder every 20-30 minutes to stand, stretch or move to make you get up for a few moments or simply going out for a 20 minute walk at lunch are good practices. Swiss balls can be good to sit on for short periods during the day to stimulate the core muscles and promote an upright posture however in most cases we wouldn’t recommend using all day as it could be asking too much of your muscles much like the perching posture mentioned earlier.
When issues do arise it is generally best to seek professional advice sooner rather than later and all of our chiropractors, physiotherapists and soft tissue therapists are well placed to discuss your individual situation. Generally speaking the sooner we get going with advice, exercises and treatment the quicker the issue can hopefully be managed. To book an appointment call us on 0117 9420200 or you can book online.